Data Subject Access Request (DSAR) Form

Use this form to submit a Data Subject Access Request (DSAR), including requests to know, correct, delete, opt out of sale/sharing, or receive a copy of your personal information.

Number Name (if

Name

First

Last

Phone Number

Mailing Address

I am submitting this request as

Type of request (select all that apply)

Right to know / access my personal information
Right to correct my personal information
Right to delete my personal information
Right to opt out of the sale or sharing of my personal information / targeted advertising
Right to data portability (receive a copy of my information)

Please describe your request in detail

Include any additional information that will help us process your request (e.g., account or loan reference number, specific categories of information, or the reason for your request).

Account or Loan Reference Number (if applicable)

Certification

I certify, under penalty of perjury, that I am the consumer identified above, or an authorized agent acting on that consumer’s behalf, and that the information provided in this request is true and accurate to the best of my knowledge.